Proposed rate hikes bring more scrutiny to MNsure

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Nuance? You can’t handle nuance! Amid the meltdown over MNsure’s startling (proposed) rate increases, Christopher Snowbeck of the Strib reports, “Premium increases announced Thursday were justified by actuarial evidence showing that care costs are exceeding premium revenue, said Commerce Commissioner Mike Rothman during a news conference near the Capitol. Rothman said insurers pointed to sicker, more costly patients in the individual market, plus rising prices for health care services. … ‘The bottom line here is that premiums are expensive because health care is so expensive,’ said Jim Schowalter, chief executive of the Minnesota Council of Health Plans, a trade group for insurers.” So take two $100 aspirins and chill out.

Tom Scheck of MPR follows his earlier story saying, “The Commerce Department acknowledged Thursday as it released the rate hikes that changes are needed. Rothman conceded that many Minnesotans won’t be able to afford coverage through MNsure given the coming hikes. Rothman also said he wants commerce officials to examine HMO reserves and look at creating a cap on HMO profits. He also called on the Legislature to create new state-based mechanisms to hold down rates including a new reinsurance program.”

But UCare is back … in one county. The AP says, “One Minnesota insurer that sued the state after losing most of its public program contracts is getting them all back. Another company in a similar situation isn’t so lucky. UCare and South Country Health Alliance filed lawsuits this summer after losing competitive bids for contracts to cover low-income residents … . The Department of Human Services announced Thursday it will restore South Country Health Alliance in all 10 southern Minnesota counties it sought to win back. But UCare will get just one county back after the mediation process — Olmsted County.”

Also in nuance, Josh Verges of the PiPress says, “Labor and social justice groups campaigning against Minnesota’s largest banks have taken their fight to St. Paul teacher contract negotiations. Minnesotans for a Fair Economy and their allies are blaming U.S. Bank and Wells Fargo for what they say is the state’s underinvestment in K-12 education. In a report titled ‘With Friends Like These,’ the group says the banks’ donations to schools represent a tiny fraction of what they’ve saved by lobbying for changes to state corporate tax law.”

Bigger, brighter, ritzier. In the Strib, Kristen Leigh Painter says, “The Mall of America is about to get bigger, again. TripleFive Group of Cos. and Ryan Cos. submitted plans to the City of Bloomington for the mall’s next expansion phase, which will add more than 1 million square feet and be connected by a multi-story bridge across Lindau Lane. The move aims to keep the mega-mall’s consumers engaged by offering new destinations while also giving high-end retailers a chance to influence physical design. If approved, construction on the $500 million project would begin as early as April with a grand opening scheduled for the fall of 2018.”

Also in (body-cam) video. From the Duluth News-Tribune: The Duluth cop talking a guy out of a suicide leap. A dramatic body camera video released by Duluth police on Wednesday shows an officer rescuing a man who threatened to jump from the top of a downtown parking ramp. The video, recorded on Sept. 19, shows officer Joe DeJesus pulling the 32-year-old man to safety from his seat on the ledge of the Holiday Center ramp along Third Avenue West. Duluth Police Chief Gordon Ramsay posted the video to Facebook, where it was being widely shared.”

You must wait longer, Sandpiper. Says Robb Jeffries of the Forum News Service, “The state Public Utilities Commission voted to suspend its approval of a key permit needed for the Sandpiper pipeline after the Minnesota Court of Appeals ruled the commission erred in not conducting an environmental impact statement before granting a certificate of need. Now, the commission and objecting parties are in a holding pattern to see if the proposers of the project, Enbridge Energy and its subsidiary North Dakota Pipeline Co., will file an appeal of the court ruling to the Minnesota Supreme Court by the Oct. 14 deadline.”

Better than your average midwestern state.Karlee Weinmann at Finance & Commerce writes, “The state scored a region-leading 53.0 in the Mid-America Business Conditions Index, Creighton University’s monthly survey of supply managers that looks at the business climate across the Midwest. Values greater than 50 indicate economic expansion in the next six months. Lower scores suggest a shrinking economy. September’s upswing brings Minnesota closer to levels it hit over the summer, restoring confidence after a sluggish start to the year. The state lost some ground in August when its score dropped to 51.9 from 54.8 a month earlier – a high point driven by manufacturers’ success.”

The exoneration though is the tough part. The AP reports, “A bipartisan group of state lawmakers is moving to dramatically restructure compensation rules for people wrongly convicted in Wisconsin, introducing a bill Thursday that would raise the maximum payout from $25,000 to $1 million and remove the cases of those exonerated from the state’s public court database. Wisconsin currently offers the wrongly convicted $5,000 for every year of incarceration, up to $25,000. Under the bill, an exonerated person could collect $50,000 for every year behind bars with the total payout capped at $1 million with adjustments for inflation every five years.”

In neighborhood news, Eric Roper of the Strib reports, “A yearslong debate over the development of a Linden Hills corner that once housed a Famous Dave’s barbecue restaurant may soon come to a close. Despite objections from a crew of vocal neighbors, a key city panel on Tuesday voted unanimously to approve a four-story, 29-unit apartment project for the site at 43rd Street and Upton Avenue. It’s the fourth proposal for the site in the last three years after others failed to materialize or were rejected by the city.”

Comments (8)

As was discussed yesterday having “more costly patients”- pre existing conditions- in the individual market alone was going to blow the doors off the rosy predicted costs (remember every one would save $2,500 per year) that so many wanted so badly to believe. The next phase that will be thrown at us is single payer is the answer. As with so many liberal ideas, it sounds simple and efficient but ask yourself what Federal Government national policy is simple and efficient?

You may not have one that you care to share (people opposed to anything “liberal” rarely do), so how ’bout this: We go back to the way things were before “Obamacare” and “MNSure,” only we get rid of Medicare and Medicaid while we’re at it, and just get the government out of the Health Care Business entirely, and “let The Market decide”?

If everyone over age 65, and everyone benefiting from those terrible government programs like Medicaid, MinnesotaCare, and whatever other health care assistance is provided by taxpayers, and were left with no alternative than what The Market had to offer, and (in its current form) insurance companies “picked them up,” how much do you think your, and other people’s, monthly premiums might increase?

Or do you figure they’d they go down because of the incredible competition (or population decline?) that would result once the insurance companies got their hands on all those older and poorer people that, no doubt, would have a huge number of “preexisting conditions”?

And just a bit of trivia, but did you know the term and contemporary meaning of “preexisting condition” didn’t exist before the insurance industry invented it as a means to ensure they wouldn’t get stuck with paying the cost of sick people’s health care?

Anyway… To get back to my original question, given that you seem to be opposed to any kind of “liberal” approach, what would you suggest as the best way to make health care affordable for the entire American Public? Nothing unrealistic or unproven, of course, but something closer to the affordability level of, say, Italy, Great Britain, France, Germany, Canada, Switzerland, or, of all places, Taiwan, where they seem to be getting it done (delivering equal or better “health care outcomes” for ALL citizens) for 1/3 to 1/2 the price per person.

To change the current run towards single payer we should 1st, break up state monopolies of healthcare and allow buying across state lines, same for clinician licensing. 2nd give Medicare enrollees a means tested voucher to choose any healthcare plan they want. 3rd give workers control over their healthcare dollars with a healthcare savings account and allow them to get coverage from any source they choose. Individuals will choose what is best for themselves, Big ,Government will choose a program that best fits their agenda, controlling more money and another aspect of your life because of course they know what is best for us unenlightened folks.

All I’d like to know now is how what, specifically, in what you suggest is going to lower the cost of health care access by 1/3 to 1/2 for all Americans (like the health care access approaches countries around the world have implemented, the models of which are readily available on this thing called “the internet”)? How big will the cost savings be, and how long will it take for them to materialize in American’s/Minnesotan’s lives and bank accounts? Do you have any insight or information on that aspect of things?

Republicans will soon be blabbing long and loud about what a failure MNSure and “the government” is, and it’s likely many Democrats will be doing some hem and haw dance in efforts to defend, explain or deflect the jump in health care insurance premiums available through the exchange.

But before everyone starts jumping onto either side of the bandwagon, I urge all concerned to take a much closer look at the ugly reality related to these ideas, expressed above:

The Bulletin (for defenders and detractors alike) is MNSure, or “the govenment,” or “Obamacare,” or even “insurance companies” (although they’re nowhere near innocent bystanders), are NOT the entities to focus all your concerned energy on when it comes to increases in health care insurance costs. Those things are being set and driven by the entities providing the Public with those products and services, and these ideas, also expressed above, point directly to where the attention, energy and rhetoric ought to be focused:

“examine HMO reserves and look at creating a cap on HMO profits”

“called on the Legislature to create new state-based mechanisms to hold down rates”

The only adjustment to those two ideas I’d suggest is changing the last word, “rates,” to “health care product and service provider costs.”

Hospitals and their administrators, Health Maintneance Organizations, the companies that make and sell everything from pacemakers and MRI machines to bandaids, gauze pads and $100 aspirins, to the companies that provide “contracted services” to hospitals and clinics. What are THEIR rates? What percentage have THEY increased over the past one, five, ten, fifty years?

Rumor has it some of those rates will be increasing by as much as 49%. That’s interesting. How come? Did nurses, health care assistants, and all the other people working to deliver that care get huge raises in the past year? Did hospitals cost of electricity, or the cost of the new bricks and windows and wiring and construction labor involved in the new health care facilities they’re building increase by 49%?

Which costs, which services have increased SO much and SO fast that, all of a sudden, the Public will just have to shell out as much as 49% more for them or go back to the nervous-making reality of maybe having to face bankruptcy by dropping insurance coverage they, the Public, cannot afford?

What’s needed in Minnesota is a Medical Services Industry (including insurance) equivalent of the Public Utilities Commission. What’s needed in Minnesota is pricing scrutiny that goes way beyond the Commerce Commission doing whatever scrutiny they can of the (purposely obscure and opague) “costs” of a health insurance industry that is the “front,” or “middleman,” or “shock absorber,” or “smoke screen,” for the real cost generators, Minnesota’s non-insurance-related health care products and services providers.

Again: Although some people just love to demagogue the topic for all it’s worth (in terms of things that make no sense but “sound logical”), it is NOT MSure or “the government” that is jacking up the price of health care, anymore than it would be MNSure or the government jacking up the price of a Ford F-150 to $125,000, or a Chevy Malibu to $200,000, if that’s what Ford and Chevy thought they could get away with (because they knew the Public had to get around and had no alternative to their vehicles).

If the Commerce Commission has determined that a health care insurance rate increase of as much of 49% is justified because of increases in the cost of health care products and services, it would seem MORE than logical for them (or some other Commission) to take a much more in-depth look at WHY those costs have increased that much instead of just taking the health care insurance industry’s word (and “proof”) for it that THEIR costs have increased that much… That could be. But, if so, what is the explanation for the increase in their costs, beyond the generalities of the “rising prices for health care services.”

The Minnesota Public (who will be paying the bill) deserves better answers than that — AND a MUCH better answer than “It’s MNSure’s and Obamacare’s and the government’s fault!” — for a staggering increase in cost to the Public of as much of 49% in one year.

Give me a break… No other business on the planet (besides, maybe, some defense contractors) could get away with a one-year cost increase of 49% and have any customers left.

Why does ObamaCare have an open enrollment period? So people don’t game the system and pay premiums only when they need care, right? That is why insurance companies on the individual side denied uncovered folks with pre-ex. Why pay premiums when healthy? Sort of like you can’t get car insurance after an accident or homeowners when your house is on fire. common sense is all. Our premiums are reflective of the cost of health care. If those other countries are doing it for less then their docs, clinics and hospitals get less than ours do. The other countries also ration to some extent to save money.

Preexisting or not conditions (a secondary issue, if one at all), what do you recommend as the better alternative to what we have now?

And, regarding this…

“If those other countries are doing it for less then their docs, clinics and hospitals get less than ours do. The other countries also ration to some extent to save money”

… are you sure about that, or are you just “figuring” that must be the reason the rest of the “industrialized world” is able to outperform America’s health care system for so much less money? How much less are those docs, clinics and hospitals getting, and what kind and how much rationing are they actually doing?